We no longer support this version of your browser.
We recommend that you upgrade to the latest version of Internet Explorer, Firefox, Chrome or Safari to improve your security and experience using this website.

Comparison of Immune Globulin Products

Intravenous immune globulin (IVIG)
products are made from human plasma.
Over the years, products have come and gone as manufacturing processes
have become safer.14 All but one available IVIG product are
indicated for primary immunodeficiencies, while not all are indicated for
immune thrombocytopenic purpura, etc.
More than half of IVIG use is off-label.
There’s an increased risk of anaphylaxis with use of IVIG in patients
with IgA deficiency, especially with products that have higher concentrations
of IgA. IVIG is generally contraindicated
in patients with IgA antibodies and a history of hypersensitivity.14
However, Gammagard S/D can be used for patients who have not had an
anaphylactic or serious hypersensitivity reaction to a 5% IVIG product with
<1 mcg/mL of IgA.4,14 Tolerability
of the different IVIG products isn’t always predictable.14 Starting therapy with a low concentration and
infusion rate, usually 0.5 mg/kg/min, may help prevent infusion-related reaction
(chills, nausea, etc). This may be
especially true when patients start therapy or switch products. In addition, a lower concentration and
infusion rate may help reduce the risk of kidney damage and thrombosis in
patients at risk. Other ways to lower
risk of adverse effects include avoiding products with sugar-based stabilizers
and using products near physiologic osmolality/osmolarity (around 300 mOsm/kg
or 300 mOsm/L).13,14
Premedication with acetaminophen and an antihistamine 30 to 60 minutes
before infusion of IVIG is a common practice for reducing the risk of
infusion-related reactions in some patients.
When dosing IVIG products, consider data that support using ideal body
weight rather than actual body weight. For
obese patients, data are limited with regard to whether an adjusted body weight
or ideal body weight should be used.10,11,15,27 The following chart compares the IVIG products available in the U.S. Subcutaneous infusion and IM immune globulin
products are also included (see more info below the chart).

Brand Name
Formulation
Route

FDA-Approved
Indications

Product Specifics

Storage

Comments

Asceniv23

10%
liquid

5
gm bottles

IV
infusion

Primary immunodeficiencies

IgA: ≤200 mcg/mLOsmolality: Not available from manufacturer.Stabilizer: glycine and polysorbate 80

Refrigerate unopened bottles.

Dilution is not
recommended.

Filter
not
required.

Bivigam16

10%
liquid

5,
10 gm bottles

IV
infusion

Primary immunodeficiencies

IgA: ≤200 mcg/mLOsmolality: ≤510 mOsm/kg21Stabilizer: glycine

Refrigerate unopened bottles.

Dilution is not
recommended.

Filter
not
required.

Cutaquig**24

16.5%
liquid

1,
1.65, 2, 3.3, 4,
8 gm bottles

Subcutaneous
infusion only

Primary immunodeficiencies

IgA: ≤600 mcg/mLOsmolality: 310 to 380 mOsm/kgStabilizer: maltose

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

Dilution is not
recommended.

Filter
not
required.

Maltose may falsely elevate blood glucose with some glucometers and strips.

Cuvitru**17

20%
liquid

1,
2, 4, 8, 10 gm bottles

Subcutaneous
infusion only

Primary immunodeficiencies

IgA: 80 mcg/mL Osmolality: 280 to 292 mOsm/kg
Stabilizer: glycine

Store unopened bottles at room temp
or refrigerated. Storage duration at
room temp is shorter. See product
labeling for details.

Dilution is not
recommended.

Flebogamma
5% DIF2

5%
liquid

0.5,
2.5, 5, 10,

20
gm bottles

IV
infusion

Primary immunodeficiencies

IgA: <50 mcg/mLOsmolarity: 240 to 370 mOsm/kgStabilizer: sorbitol

Store unopened bottles at room
temp.

Dilution is not
recommended.

Filter not required.

Flebogamma 10%
DIF12

10%
liquid

5,
10, 20 gm bottles

IV
infusion

Primary immunodeficiencies

Immune thrombocytopenia

IgA: <100 mcg/mLOsmolarity: 240 to 370 mOsm/LStabilizer: sorbitol

Store unopened bottles at room
temp.

Dilution is not
recommended.

Filter not required.

Gamastan***25

16.5%
liquid

2 and 10 mL bottles

IM
injection only

Hepatitis A prophylaxis

To prevent or modify measles, and
to modify rubella or varicella in specific patient populations.

IgA: Not applicableOsmolarity: Not applicableStabilizer: none

Refrigerate unopened bottles.

Dilution is not recommended.

Filter not required.

Gammagard Liquid3

10%
liquid

1,
2.5, 5, 10, 20,

30
gm bottles

IV
or subcutaneous** (for primary immunodeficiencies only) infusion

Primary immunodeficiencies

Multifocal motor neuropathy

IgA: 37 mcg/mLOsmolality: 240 to 300 mOsm/kgStabilizer: glycine

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

If bottles are pooled to make a
dose, start the infusion within eight hours after pooling.*

If diluent is used, choose D5W.

Filter not required.

Hizentra**7

20%
liquid

1,
2, 4, 10 gm bottles

Subcutaneous
infusion only

Primary immunodeficiencies

Inflammatory demyelinating
polyneuropathy

IgA: ≤50 mcg/mLOsmolality: 380 mOsm/kg21Stabilizer: L-proline

Store unopened bottles at room
temp.

Dilution is not
recommended.

High
concentration
may be advantageous in patients who are volume restricted.

HyQvia**20

10%
liquid

2.5,
5, 10, 20,
30 gm bottles

Subcutaneous
infusion only

Primary immunodeficiencies

IgA: 37 mcg/mLOsmolality: 240 to 300 mOsm/kgStabilizer: glycine

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

Dilution is not
recommended.

Formulated
with recombinant human hyaluronidase to temporarily break down tissue and
facilitate delivery of a higher volume of immune globulin by subcutaneous
injection.

Octagam 5%8

5%
liquid

1,
2.5, 5, 10,

25
gm bottles

IV
infusion

Primary immunodeficiencies

IgA: ≤200 mcg/mLOsmolality: 310 to 380 mOsm/kgStabilizer: maltose

Store unopened bottles at room
temp or refrigerated.

If bottles are pooled to make a
dose, start the infusion within eight hours after pooling.*

Dilution is not
recommended.

Use of an in-line filter between 0.2 and
200 microns is optional.

Contraindicated in patients
with corn allergy. Maltose comes from corn.

Maltose may falsely elevate blood glucose with some glucometers and strips.

Octagam 10%19

10%
liquid

2,
5, 10, 20, 30 gm bottles

IV
infusion

Immune thrombocytopenia

IgA: 106 mcg/mLOsmolality: 310 to 380 mOsm/kgStabilizer: maltose

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

If bottles are pooled to make a
dose, infuse within eight hours after pooling.*

Dilution is not
recommended.

Use of an in-line filter between 0.2 and
200 microns is optional.

Use
with caution
in patients with corn allergy. Maltose comes from corn.

Maltose may falsely elevate blood glucose with some glucometers and strips.

Panzyga26

10%
liquid

1,
2.5, 5, 10, 20,
30 gm bottles

IV
infusion

Primary immunodeficiencies

Immune thrombocytopenia

IgA: 100 mcg/mLOsmolarity: 240 to 310 mOsm/LStabilizer: glycine

Store unopened bottles at room
temp or refrigerated. Storage duration
at room temp is shorter. See product
labeling for details.

If bottles are pooled to make a
dose, infuse within eight hours after pooling.*

Dilution is not recommended.

Use of an in-line filter between 0.2 and
200 microns is optional.

Privigen9

10%
liquid

5,
10, 20, 40 gm bottles

IV
infusion

Primary immunodeficiencies

Immune thrombocytopenia

Inflammatory demyelinating
polyneuropathy

IgA: ≤25 mcg/mLOsmolality: 240 to 440 mOsm/kgStabilizer: L-proline

Store unopened bottles at room
temp.

If bottles are pooled to make a
dose, start the infusion within eight hours after pooling.*

If diluent is used, choose D5W.

No filter required.

Xembify**1

20%
liquid

1,
2, 4, 10 gm bottles

Subcutaneous
infusion only

Primary immunodeficiencies

IgA: not available from manufacturerOsmolality: 280 to 404 mOsm/kgStabilizer: glycine and others

Store unopened bottles at room
temp or refrigerated.

Dilution is not recommended.

No filter required.

*Storage requirements and beyond-use
information after preparation is given based on the assumption that the product
was prepared in a laminar flow hood.

**Although
not an IVIG formulation, product is included because some patients may be
switched to subcutaneous infusions from IVIG. Check product labeling for how long a patient
should be maintained on IVIG before switching, and for the recommended interval
between the last IVIG dose and the first subcutaneous dose (usually one week).1,3,6,7,17,18,20,24

***Not
an IVIG formulation, but product is included to contrast indications and for
completeness.25